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Friday, March 8, 2013

It can get better


It can get better

The year was 1991 and I had been medically discharged from the Navy and working for the USPS as a letter carrier in Fallon for three years by then. One of the medical issues that I was dealing with was pain in my right shoulder, for which I had been treated while on active duty and was a chronic problem.

Being a veteran and with the price of medical care being what it was even then, I was encouraged to seek treatment at the VA Hospital in Reno. I must tell you that it was not a good place to go in those days. At best the chance of actually getting treatment was unreliable, and the delays for everything that you did get were legendary. Horror stories were rampant and true.

I was sent to the VA Hospital to see the Orthopedic Specialist for evaluation of my shoulder for surgery. Would it (surgery) improve my condition or not, was the $64,000 question of the day.

In those days (1991) they played a weird scheduling game at that specialty clinic. You had to report in between 08:00 and 09:00 a.m., regardless of when your appointment time was. Then you would wait in a kind of "stand by" mode until your scheduled time arrived.

This oddball process was initiated and enforced by the lead doctor, and the man that I was to see, Dr. F. (He whose name must not be spoken, for he will sue.) He felt that his time was too valuable to have any blank spots in his day, but obviously felt that the veteran’s time didn’t matter.

With Dr. F’s plan the patients were stacked up like cans in a soda machine waiting to move forward should a cancellation happen. Of course the doctor could (and had done so in the past) walk out the door at any time and cancel the rest of his day, like if an emergency golf game popped up. No, I am not kidding.

This meant a five hour wait for me with my 1:00 pm appointment. I was already angry from having to park a mile away from the hospital and hike in as that day was Tuesday which was "clinic day." People in the know, arrived there early to get a parking spot.

It was my first visit to this particular clinic and I didn't know the hospital very well at all. Parking was on the opposite side of the hospital from the main entrance, so I was coming in through the back of the hospital, which had me all turned around. Fortunately, by habit I always arrive early for any appointment. Otherwise the walk in and then wandering lost through the building would have made me late. I was hustling to make 08:00, but I found the main administration area and check in desk, and got my name in by the hour.

I plopped down in a chair with my back to the wall to wait and sat there observing the activity around me. I never heard anybody called for "Ortho," or any other clinic for that matter. After thirty minutes of being patient, I asked the guy sitting across from me which clinic he was waiting for. I don’t know if he was a jerk, or just deaf, because he moved his paper up in front of his face and said nothing.

Fifteen more minutes passed and I got nervous. I got out of my chair and went back to the desk where I checked in to ask the lady there why no one was being called.

The shock of being told that I was in the wrong waiting area jacked my blood pressure right up! I really had to focus on the instructions as to which hallway, and how many turns, etc., would get me to the orthopedics waiting area. It was almost 09:00 and I was in the wrong place! I would say that I was having an anxious moment, or adrenalin spike, or something. Making a mistake like that upsets me, even though it may not have been my fault.

Feeling slightly better armed with my new instructions on where to go, I walked away from the desk directly towards a glass wall with doors to the outside. That was where I had to turn and proceed down a hall.

Coming through the door from the outside, was an elderly man wearing a WWI veteran cap being pushed in a wheelchair by a young black man wearing hospital scrubs. Not being in so much of a hurry that I couldn’t show respect and help, I stopped to assist with the door. The orderly didn’t pay any attention to me at all, but I got a smile and a nod of thanks from the old vet, which made me feel good.

As I turned to hurry on while looking at my watch, I heard the old man say to the orderly, "Please, I have to pee, can you take me to the bathroom?" To which the young man said, "You will have to wait" as he parked the wheelchair against a wall and locked the wheels. As I looked back while still walking, I could see the orderly going back outside. I seriously regret not having gone back to the old man's aid at that point.

I was immediately lost again and in a frantic hurry. I’m sure it was because I was still thinking of being late and losing my appointment. If I had been thinking logically I would have realized that with a 1:00 p.m. appointment, I had several men ahead of me and was in no danger of being dropped.

To explain: If they called your name and you were not there, you were removed from the list and had to reschedule. The appointments in that plan were set for one every fifteen minutes. This doctor was a civilian with a contract, not a VA employee, and got paid by the body count. This was truly factory assembly line medicine!

I found the clinic and checked in with the gum popping young lady behind the counter. She told me to have a seat and do not under any circumstance, leave the waiting room without telling her or my appointment would be cancelled and I would have to reschedule. I resented the Hell out of her attitude and instantly wanted to slap the gum out of her mouth. But I did not.

There was no doubt that I was angry with myself for not helping the old man get to the bathroom before being placed in this holding pen. It just felt like I had done something wrong, again.
If you add that to the stress of finding a parking spot in an unfamiliar area, getting lost in the building twice, being in the wrong waiting room, etc, I was agitated. It had not been a good morning. Going to the doctor was proving to be harmful to my health.

Finally, it was 1:00 p.m. and my turn. Obviously being there hours early had done me no good at all. The doctor was observed sauntering slowly back in from lunch like he had nowhere important to be. As I listened to him interact with the staff, it was apparent that he was just as arrogant and abusive with his receptionist as I had been told that he was with patients.

I was his first appointment after lunch, so I thought, “OK, he should be in a good mood and we could get through this.” For sure, I was not looking forward to the manipulation of my shoulder that I had learned to expect from other examinations. It hurt when I was required to push the rotation to the range of movement limits and then for hours afterwards. That was part of why I was there, something was obviously wrong with the joint. Rotating your arm was not supposed to hurt.

My name was called and I fairly shot out of my chair, such was my preconditioning to not miss my turn. I was escorted back to the examination room by the young woman I checked in with. Which I thought was kind of odd; to have a receptionist leave her post was unusual. That task was usually done by a nurse.

The gum popping girl complained all the way down the hall that the nurse didn't come back from lunch with the doctor and now she had to do her work too. I can remember thinking to myself, "Honey, you couldn't empty a bed pan without screwing it up; you could never be a nurse."

When I moved towards a chair to sit down I was told (rather than asked) to sit on the exam table and wait for the doctor. Again I had the urge to smack the gum out of this rude young woman’s mouth as she popped a bubble for punctuation to her order. I recall thinking, “Yeah, you had better stay at your reception desk, you wouldn’t make it one day as nurse.”

Being the well conditioned soldier, I complied with my orders and sat on that uncomfortable examination table with my legs dangling and nothing to rest them on. I spent my waiting time studying all of the medical posters with joints and bones exposed showing the workings. At least that was interesting, and didn’t chew gum.

After a few minutes, Dr. F. burst into the room, kind of flailing like he was tossed in there. He was steadily writing in my chart and didn't glance my way or even speak to me as he went to a desk at one side. It was as if I wasn’t even there.

Tossing my chart on the desk, he picked up the telephone and dialed a number. "Oh damn," I thought, he saw something in that chart and is ordering some kind of immediate procedure. Will they admit me and keep me here?” You always expect the worst case scenario when you go to a doctor’s office; it is some kind of bizarre conditioning thing.

That fear bubble burst when the doctor started talking to the person on the other end of the telephone line. He was arranging a golf game! He completed that call and instead of turning to address me and apologizing for the delay, he immediately dialed another number and spoke to another golf buddy. This repeated until he had arranged his golfing foursome.

Finally done with his priorities, he picked up my chart and wrote in it once again. He then looked up at me and said, "Come back and see me in two weeks." Throwing my chart in the "completed" bin, he got up and turned to leave the room. The man was so impersonal, that I felt like he completely disrespected me as a veteran or even a human being by his actions.

I was way beyond angry at that point and fairly jumped from my seat on the examination table, to a position blocking him from leaving the room. I got nose to nose with this medical "unprofessional" and was probably spitting on him as I spoke, I was so mad.

"How dare you use my fifteen minutes of time for your golf date calls after I have waited all damn day to see you! How dare you write in my chart without ever even looking at me, much less examining me you arrogant quack!" I know that this is exactly what I said because the receptionist wrote it all down and I was presented with the details later in a written "denial of service letter."

The doctor went "bug-eyed" and started screaming for the receptionist, alternating between "Get out!” and "Help, get security!" I did turn and leave at that point, as I knew that I was never going to let this guy work on me, even if he would have.

The fortunate thing for both of us was that he did not put his hands on me. It would have ended very badly for him. I was completely calm by that point, which I knew from experience, could be very bad. It was a precursor to physical violence.

I left the orthopedic clinic and not knowing how else to get out of the building, I retraced my path back to the main administration area where I first checked in. It was probably the longest possible route to exit the hospital, but it was the only way that I knew.

As I walked I could see the old man sitting in his wheelchair from down the hall, exactly where he had been "parked" hours before. When I got closer I could see the man visibly sobbing and that there was a puddle under his chair, which made me walk faster.

Almost to him, I could now see and hear the young orderly approaching from the doorway. Speaking in a very harsh and menacing tone he said to the old veteran, "Now look what the Hell you done did! I am gonna have to clean up that mess you made! Sorry old..." and was raising his hand, as if to strike.

That was as far as he got, as my fingers closed around his throat and I slammed him against the wall, lifting him just off of the floor by his neck. His eyes were bulging as I choked his windpipe and I quietly said to him, "You owe your freedom and your very existence in this hospital to this man. Is this how you repay his service to our country?"

That orderly truly owed his life to the very man that he abused. As I was closing off his airway, the old man said, "Please don't kill him, he isn't worth it." I just said, "Yes Sir" and dropped the younger man to the floor.

Could I have killed him? Yes, easily. I am well trained to do so. Would I have killed him? I don't know. I was very angry, but was still under control or he would have died instantly.

Hospital Security was already walking through the building looking for me after my run in with the orthopedic Doctor. They wanted to locate me, although they couldn't really "do" anything to me for just yelling at that creep. So, they were right there on the spot when I made that latest “crazy man” scene.

Given the circumstances and hearing from the witnesses who sprang (if one can spring from wheelchairs and crutches) to my defense, the security guards were very nice to me and asked me to please accompany them. I expected handcuffs and some shoving around and was already embarrassed by what I considered as "losing control" on my part.

By that I mean, I should have at least warned/threatened the guy first, before putting my hands on him. Unfortunately, that just wasn't how I was trained to react to a perceived threat. The orderly was advancing upon and threatening the elderly veteran in my eyes. So, I just reacted and moved by instinct to counter (or remove) the threat.

I was taken into the administrative office and questioned by the security supervisor as we waited for the Reno PD to show up. Their procedure was understandable, because I had laid hands upon another person the police had to be called.

The hospital security guys kept coming to the door and speaking to their boss. They were repeatedly relaying more witness statements and information. Their comments including saying Dr F's name and laughing (when safely out of earshot of the supervisor) at what a jerk he was to them. Even though they greatly disliked the doctor they were still afraid of the clout he had with the hospital administration.

I must confess that as I waited in that office I had scoped out the exits and planned how I would get out of the building to my vehicle should they want to arrest me. I was NOT going to a jail cell. My severe claustrophobia would have required full time sedation to lock me up.

The Reno PD guys arrived with one slender but hard looking blond white guy, and one very large black man that filled the doorway with muscles. Both of them had serious haircuts and their deportment confirmed my evaluation of their background, at least to me. You could almost see the "thread marks" on their skulls; they were "jarheads" (Marines) all the way. Semper Fi!

I sat still and behaved myself as the officers conducted the business they had to do. The two men smiled at me as they listened quietly to what was being said by the hospital security supervisor. They also interviewed the other security guards and all of the witnesses who had stayed around to the last man to be heard.

Finally, the orderly that I had choked was brought forward for his statement. He sneered at me when bopped into the room like he was a gangster with an entourage following him. The policemen were watching me for a reaction, but I showed no emotion. In truth I thought that the man was pathetic and didn’t warrant any further effort on my part.

The young man mistakenly figured that he could play the "race card." He started off his case all wrong by calling out to the black officer, "Yo homey, we got to stick together when whitey tries to put us down. You need to bust cap in that honky's ass. Or I WILL." (Verbatim, from the transcripts) and then started towards where I was sitting.

Both officers moved as one to intercept and stop the possible confrontation. The black officer almost cat-like, was instantly in front of the young orderly. His partner positioned himself to block me should I attempt to engage. The blond officer smiled as he saw that I was not moving and that I was unimpressed with the bravado and noise. He nodded at me and turned his attention back to his partner. I suspect that they had served together in the Marines or at least had been partners for a while, because they were very much in tune with each other's actions.

The bigger officer leaned slightly forward from the waist with his hands on his hips, in a fashion reminiscent of a drill sergeant, and addressed the young man saying, "First, I am NOT your homey, I am Officer "X" and I just heard you make a threat of violence. Should anything happen in the future what you said will be a matter of record and I will personally come looking for you. Second, I think that you had better be careful what you ask for, you may not be so lucky next time," and looked in my eyes and nodded to me.

There was another, much older, white orderly (either a union rep, or a supervisor) trying to quiet and restrain the young man, without much success. The man finally grew exasperated and said, "Will you shut up and come with me! We need to get you checked out." He then led him away.

The RPD officers asked me to come with them, and we walked out the doors on the opposite side of the building. When we got outside, the white cop said, "What you did was assault on one hand, and justifiable prevention of assault and continued abuse on the other. No way are we going to charge you for defending a helpless old veteran. If any law suits happen from this we will testify on your behalf. Now it's probably a good idea if you go back home to Fallon in case this guy has any hot headed friends in the area. We don't need any more trouble." His partner smiled at me and chimed in, "Or any bodies should my mouthy "homey" jump up in your face."

I gave them a departing "Semper Fi!" to which I got "Ooh Raw!" in unison from the officers.

It was more than twenty years after that event before I even considered utilizing the VA services that I was entitled to. I was thoroughly convinced that the Veterans Administration was just another screwed up government agency and not worth the trouble.

It was not until a field clinic was opened in my town, staffed by people that I respected that this changed. The personnel of the Fallon VA Clinic were able to convince me that it was worth another chance. I have known the doctor who works there for more than twenty-five years. He used to be my civilian physician. The girl working the reception desk used to work with me in the Navy. The office manager worked at another medical office and I encouraged her to take on the VA Clinic job when it was offered. They were all friends that I trusted.

I am happy to report that the Reno VA Hospital is a far better environment today. Veterans of all ages are treated with dignity and respect. Every effort is made to serve the patient. You are no longer treated like an inconvenience that they have to put up with, but as the very reason for their existence. Care there is excellent.

It was worth the twenty plus years it took to return, it is better place today.

P.S.

I always get asked this when I tell this story, "What happened to the orderly?"

The word got around pretty quickly of his abuse of the old WWI Vet and by the end of that day, no one wanted to work with him. I mentioned to a neighbor who worked in the top administrative office at the VA hospital what had happened (so that she heard it from me and not rumors) the same day that it took place. I know that she made telephone calls when she went back inside, because I could see her on the phone through the window. The next day when I delivered her mail she informed me that the man in question no longer worked at the VA Hospital in Reno, having sought employment elsewhere due to a "hostile work environment." I never saw him again.

I also learned later (from my admin. friend) that the old man, who was an inpatient there, passed away a few months afterwards (in the hospital) from complications from his war wounds. He had been shot multiple times and had been gassed in the trenches in Europe. The man had every medal there was (except for the Medal of Honor), including three purple hearts.
He had entered the service at age 16 and didn't come home until it was over, over there. The old soldier had lived his entire life carrying metal fragments in his body and dealing with damaged organs from his service. He was buried with honors in the Veterans Cemetery in Fernley, NV.

I am glad that I defended him and I am still sorry that I didn't take action to prevent his humiliation of wetting himself. Lesson learned; never hesitate to do the right thing.

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